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<head>
	<meta http-equiv="Content-Type" content="text/html;charset=utf-8" />
	<title>体检预约服务平台 - 医通在线</title>
	<link href="templates/css/global.css" rel="stylesheet" type="text/css" />
	<link href="templates/css/agency.css" rel="stylesheet" type="text/css" />
    <script src="templates/js/form.js" type="text/javascript"></script>
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</head>
<body>

<!--header st-->
<{include file="../templates/$newtpl/header.html"}>
<FORM style="margin-top:5px" action="/index.php?action=editappend_save2"  method="post" enctype="application/x-www-form-urlencoded" name="appendform" target="_self" id="appendform">

<div class="row mb10 center_layout fix">
	<{include file="../templates/$newtpl/left.html"}>
	<div class="grid0 grid770">
		<div class="main_con">
			<div class="subline"><h4>预约登记</h4><a href="<{$__URL__}>help" target="_blank" class="yuyue"><s></s>预约须知</a></div>
			<div class="step"><img src="templates/images/stepg_2.png" /></div>
			<div class="con info_box info_make">
				<div class="info_table mb10">
					<div class="con">
						<div class="form">
						<{if $project_add.info_tbts_qtkj!=''}>
							<h6 class="mb20">特别提示</h6>
							<p class="tip_box1">
<{$project_add.info_tbts_qtkj}><br><{$project_add.info_tbts_qtkj_bold}></p>
				<{/if}>
							<h6 class="mb20">预约日期及门店</h6>
							<dl style="padding:0">
								 <dd class="fix"><label class="text span1">购买套餐：</label><{$product_info.product_name}></dd>
								<dd class="fix"><label class="text span1">1.&nbsp;使用城市：</label><select name="city" class="span1" id="city" onchange="get_supplier_list_edit('<{$appendinfo.append_productid}>');">
                                
                                    <option value="">请选择城市</option>
                                    <{foreach from=$city_list key=key item=item name=citys}>
                                     <option value="<{$key}>"  <{if $key==$appendinfo.append_city}>selected<{/if}>><{$item}></option>
                                    <{/foreach}>

			                       </select><font color="#FF0000" style="font-size:12px;">*必填</font></dd>
								<dd class="fix"><label class="text span1">2.&nbsp;选择门店：</label>

									<table class="md_table" id="ses">
										<thead>
											<tr>
												<th width=100>机构</th>
												<th width=200>门店</th>
												<th width=250>门店地址</th>
												<th width=50>选择</th>
											</tr>
										</thead>
										<tbody id="store" name="store">
										 <{foreach from=$store_list key=key item=item name=store}>
											<tr style="font-size:12px" align="left">
												<{$item}>
												<td><input type="radio" class="radiobtnfix" name='selectstore'  id='selectstore'   value="<{$key}>" onclick="get_product_list();get_store_ldtime();get_item_jx(<{$key}>);check_info('<{$key}>','<{$appendinfo.append_productid}>');" <{if $key==$appendinfo.append_storeid}>checked="checked"<{/if}>/></td>
											</tr>
											 <{/foreach}>
										</tbody>
									</table>


								</dd>


									<{if $jx_list!=''}><input type="hidden" id="no_sa" name="no_sa" value="" />
									<dd class="fix"><label class="text span1">加项信息：</label>
								<table class="md_table">
										<thead>
											<tr>
												<th width=250>加项名称</th>
												<th width=250>检测意义</th>
												<th width=100>员工价</th>
											<!-- 	<th>家属价</th>
												<th width=50>选择</th>-->
											</tr>
										</thead>
										<tbody id="store" name="store">
			                              <{foreach from=$jx_list key=key item=item name=store}>

									 <tr style="font-size:12px"><{$item}><!-- <td><input type="checkbox" class="radiobtnfix" name='selectstore'  id='selectstore' checked=checked disabled=disabled  value="<{$key}>" onclick='emptyval();get_store_ldtime();' <{if $key==$appendinfo.append_storeid}>checked="checked"<{/if}>/></td>--></tr>
						               <{/foreach}>
									</tbody>
									</table>
								</dd>
								<{else}>
			                              <input id="no_jx" name="no_jx" value='1' type="hidden" />
								<{/if}>
								<dd class="fix"><label class="text span1">3.&nbsp;预约时间：</label><div class="choose"><input name="yytime" type="text" id="yytime" readonly=""  value="<{$appendinfo.append_yytime}>"/><font color="#FF0000" style="font-size:12px;">*必填</font>
								</div><cite class="red" id="ldtime" name="ldtime"></cite></dd>
							</dl>
						    <div id="freeset" name="freeset" ></div>
							<dl style="padding:0">
								<dd class="fix">
                                    <label class="text span1">体检报告：</label>
                                        <cite><{$report_type_msg}></cite>
                                </dd>
							</dl>
							<!-- <dl>
								<dd class="fix"><label class="text span1">寄送地址：</label><select class="span1"><option>上海</option></select><select class="span1"><option>上海</option></select><select class="span1"><option>上海</option></select></dd>
								<dd class="fix"><label class="text span1">&nbsp;</label><input type="text" class="text" style="width:395px;height:20px;line-height:20px" placeholder="请输入详细地址" /></dd>
							</dl> -->
						</div>
					</div>
				</div>
				<div class="btn"><a href="/index.php?action=editappend&orderid=<{$appendinfo.append_orderid}>" title="上一步" class="btn_prev mr20"></a><a href="####" onClick="submit_append_edit();" title="提交预约" class="btn_fin"></a>
				  <input name="appendid" type="hidden" id="appendid" value="<{$appendinfo.append_id}>">
				  <input name="projectcode" type="hidden" id="projectcode" value="<{$appendinfo.append_project_code}>">
				  <input name="productcode" type="hidden" id="productcode" value="<{$appendinfo.append_productid}>">
				  <input name="orderid" type="hidden" id="orderid" value="<{$appendinfo.append_orderid}>">
				  <input name="wide" type="hidden" id="wide" value="<{$userinfo.user_wide}>">
				  <input name="oldyytime" type="hidden" id="oldyytime" value="<{$appendinfo.append_yytime}>">
				  <input name="oldstore" type="hidden" id="oldstore" value="<{$appendinfo.append_storeid}>">
				  <input name="oldproduct" type="hidden" id="oldproduct" value="<{$appendinfo.append_productid}>">
				</div>
			</div>
		</div>
	</div>
</div>

<{include file="../templates/$newtpl/foot.html"}>
</FORM>
<!--脚本如下-->
<script src="templates/js/jquery-1.7.2.min.js" type="text/javascript"></script>
<script src="templates/js/jquery.switchable2.min.js" type="text/javascript"></script>
<script src="templates/js/cal.js" type="text/javascript"></script>
<script src="templates/js/global.js" type="text/javascript"></script>

<script type="text/javascript">

	$('.choose').click(function(){
		get_edit_free_time_famliy();
	});
	get_store_ldtime();
</script>

</body>
</html>